Dysarthria is a speech disorder caused by nervous system dysfunction, often resulting from brain injuries or neurodegenerative disorders. Treatment involves speech therapy and compensation techniques, with severe cases requiring alternative communication methods or surgery.
Dysarthria is the term for a medical condition characterized by speech disorders, the origin of which is considered to be a disorder of the nervous system. As such, the condition is usually accompanied by poor muscle control of the face and neck due to dysfunction of various cranial and facial nerves. Dysarthria can also involve a number of secondary systems related to speech and articulation, such as the respiratory system. The effects of these disturbances usually produce slurred speech that lacks normal pitch and intonation.
There are many factors that can cause dysarthria. Traumatic brain injuries, strokes, or brain tumors often damage motor neurons, which are responsible for coordinating signals from various parts of the brain and brainstem to accurately execute muscle movements. Dysarthria can also result from various neurodegenerative disorders, such as Huntington’s disease, cerebral palsy, multiple sclerosis, or Parkinson’s disease. As this is the case, any sudden onset of speech impairment should be investigated without delay.
Evaluation of dysarthria is done based on the symptoms observed, which allows the doctor to classify the condition. The general qualities of speech examined are articulation, resonance, phonation and prosody (rhythm and meter), with each area being affected differently depending on the location and extent of neuronal damage. For example, spastic dysarthria is related to nerve damage along the pyramidal tract, while ataxic dysarthria is caused by cerebellar dysfunction. Flaccid dysarthria is associated with cranial nerve damage, and hyperkinetic dysarthria is associated with basal ganglia lesion formation. Hypokinetic dysarthria, on the other hand, is the result of lesions along the substantia nigra, a specific consequence of Parkinson disease.
Dysarthria treatment is primarily administered by a speech therapist, who will involve the patient in a variety of exercises to help improve pronunciation and inflection of the voice. One of the key objectives is to slow down the speed of speech to be better understood. Pacing speech can be practiced with the aid of a metronome, which prompts the patient to speak one syllable at a time in sync with the ticking of the instrument. Some speech therapists use stimulation boards or graduated sticks, which require the patient to touch or touch a designated target each time a syllable is spoken.
A number of compensation techniques can also be explored. For example, patients who have difficulty making a hard “t” or “d” sound can be encouraged to produce the sound by bringing the flat blade of the tongue to meet the teeth rather than the tip. Some patients may need to overload their pronunciation of consonants, while others may need to become more aware of the tendency to suddenly explode into loud speech. Additional therapeutic techniques involve role-play exercises and mirroring exercises, followed by the therapist eliciting the same response but without any visual or auditory cues.
Speech therapy usually improves general speech for most patients. However, severe cases may require the use of alternative communication methods, such as sign language. In some cases, surgery may help, such as modifying the throat flap. In addition, prosthetic devices, including obturators and vocal bulb implants, or noninvasive devices that synthesize or digitize speech are available.
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